螺旋CT双期增强扫描在小胰腺癌诊断中的应用

目的　研究螺旋CT胰腺期、门脉期双期增强扫描在小胰腺癌早期诊断和正确分期中的作用。方法　对14例小胰腺癌患者行螺旋CT双期增强扫描，扫描延迟时间分别为30s和65s，对比剂用量100ml，注射速度3ml/s。观察并比较正常胰腺及肿瘤在两期的增强情况。根据CT征象对肿瘤可切除性进行评价，并与手术结果比较。结果　肿瘤-胰腺对比胰腺期和门脉期分别为(47.08±20.39)HU和(28.77±16.23)HU（t=2.533,P<0.01）。14例肿瘤中，术前认为可以切除11例，术中切除9例。结论　螺旋CT双期增强扫描能更清晰地显示小胰腺癌，胰腺期肿瘤-胰腺对比较门脉期更显著，有利于小胰腺癌的早期诊断和可切除性的判断。

Dual-phase helical CT in the diagnosis of small pancreatic adenocarcinoma

Objective　To evaluate the use of dual-phase helical CT in early detection and correct staging of small pancreatic adenocacinoma. Methods　Dual-phase helical CT was performed on 14 patients with small pancreatic adenocacinoma with 100 ml intravenous contrast material injected at a rate of 3 ml/s. Pancreatic phase(PP) and portal venous phase(PVP) began at 30 seconds and 65 seconds after the start of the injection respectively. The enhancement of normal pancreas and tumor during the two phases was observed and compared. The assessment of tumor resectability based on CT findings was compared with surgical and histopathologic results. Results　Tumor-pancreas contrast was significantly greater in PP (47.08±20.39) HU than in PVP (28.77±16.23) HU (t=2.533, P<0.01). 11 of 14 tumors were thought of resectable before operation, 9 were actually resected in the operation. Conclusion　Dual-phase helical CT could delineate small pancreatic adenocarcinoma clearly and afford more information for the diagnosis and the assessment of resectability of the lesion. The tumor-pancreas contrast was much better in PP than in PVP.